Northern Colorado health care practices are bracing for many changes as they move into the new year and are preparing for even greater shifts coming in 2014.

The Affordable Care Act means changes for every kind of provider, from specialists who own their own clinics to those employed by the region’s biggest health care systems. Many of the act’s more seismic provisions will begin taking effect in 2014, turning 2013 into a planning year.

“Many of the changes you’ll see with Banner Health in Northern Colorado will be in anticipation of what we believe is happening in health care nationwide,” said Marilyn Schock, CEO of McKee Medical Center in Loveland.

Primarily, providers will be changing their focus from “volume-based care,” to “value-based care,” because of a change in the way hospitals are paid for their services.

That means it will be in the hospital’s best interests to keep patients well rather than allowing them to be repeatedly readmitted.

“We know that more of our reimbursement will be tied to outcomes and performance and the ability of payers to pay more for care that is delivered will be increasingly strained,